What is the proper way to draw blood/labs from a central line?


#1

Most hospitals probably have their own policy for drawing blood from a CVC/PICC/PORT, but I’m curious how everyone else does it.


#2

The way I was taught is to first ensure that you are allowed to draw blood from the central. Some hospitals have policies that say a peripheral sticks should be used whenever possible. Also check if the line doesn’t have TPN, heparin, or anything else infusing that could contaminate the sample. Obviously clean the port thoroughly before every step to avoid a CLABSI:

  1. Attach a 10cc saline flush and flush vigorously to remove debris with turbulence. Infuse the entire flush.
  2. Draw back on the now empty syringe, and remove a 10cc waste. Discard this.
  3. Attach an empty 10cc syringe and withdraw your sample.
  4. Attach a new 10cc saline flush and, once again, flush the entire contents vigorously to create turbulence.

Avoid the use of a vacutainer, as these run the risk of collapsing your central line’s lumen. You have a much better control over the negative pressure when you manually pull back. Also, only use 10cc syringes to pull off of central lines to avoid collapsing the line from the negative pressure.